1.Primary Care Physicians' Attitudes to Community-Based Medical Education and the Wave Model as a New Teaching Method in Ambulatory Care Settings.
Kyoung kon KIM ; Hee cheol KANG ; Chan kyong KIM ; Hi jung CHO ; Bang bu YOUN
Korean Journal of Medical Education 2005;17(3):257-266
PURPOSE: In order to expand and improve community-based medical education (CBME), we attempted to delineate the characters of the primary care physicians interested in medical education and their opinions on the new medical teaching method for ambulatory care settings, Wave model. METHODS: Through mailed questionnaires, we asked the Seoul members of the family physician association and the internal medicine physician association about their interest and opinions of CBME and the Wave model. RESULTS: We received 186 replies from the total 1088 questionnaires (17.1%) sent out. Many of the primary care physicians (141/186; 75.8%) had no experience with CBME. However, 127 (68.7%) were interested in CBME and 121 (65.4%) answered that they were interested in teaching students in their clinic. There were 128 (69.2%) affirmative responses to the Wave model, which was much higher than that to the observation-centered method, 53 (30.3%) (p < 0.0001). Primary care physicians who have affirmative attitudes to adopting the Wave model would select this model as their CBME program (p < 0.0001). Primary care physicians willing to teach students tend to be males (p=0.0085) and younger in age (p=0.0003), have examination rooms for student-patient contact (p < 0.0001), and possess positive attitude to adopting the Wave model (p= 0.0018). CONCLUSION: There are many primary care physicians eager to participate in CBME. They view the Wave model as an effective teaching method. Factors associated with the desire to work as a preceptor include being male and younger in age. having examination rooms for student-patient contact, and possessing a positive attitude to adopting the Wave model.
Ambulatory Care*
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Community Health Services
;
Education, Medical*
;
Humans
;
Internal Medicine
;
Male
;
Physicians, Family
;
Physicians, Primary Care
;
Postal Service
;
Primary Health Care*
;
Seoul
;
Teaching*
;
Surveys and Questionnaires
2.Endoscopic Treatment of Diverse Complications Caused by Laparoscopic Adjustable Gastric Banding: A Study in Eastern Asia.
Su Young KIM ; Kyong Yong OH ; Jun Won CHUNG ; Yoon Jae KIM ; Kyoung Oh KIM ; Kwang An KWON ; Dong Kyun PARK ; Kyoung Kon KIM ; Seong Min KIM
Gut and Liver 2017;11(4):497-503
BACKGROUND/AIMS: The use of laparoscopic adjustable gastric banding (LAGB) is increasing proportionally with the obesity epidemic. However, some postoperative complications have been highlighted as major problems associated with LAGB. There is no consensus concerning the endoscopic management of these adverse events. The aim of this study was to retrospectively review the feasibility and effectiveness of endoscopic treatment for LAGB complications. METHODS: We retrospectively evaluated 352 patients who underwent LAGB between 2011 and 2015. LAGB-associated complications developed in 26 patients (7.4%). This study involved six patients (1.7%) who received endoscopic treatment. RESULTS: Types of LAGB-induced complications in our series included intragastric migration (n=3), gastric leaks (n=2), and gastric fistulas (n=1). The endoscopic treatment of these complications was successful in four of the six patients. Endoscopic band removal was successful in two patients. All gastric leaks were successfully closed via an endoscopic procedure. In two cases (intragastric migration and gastric fistula), endoscopic treatment was not sufficient, and surgery was performed. CONCLUSIONS: Endoscopic procedures afforded acceptable treatment of band migration and gastric leaks after LAGB. However, the results were poor in patients with gastric fistula.
Bariatric Surgery
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Consensus
;
Endoscopy
;
Far East*
;
Gastric Fistula
;
Humans
;
Obesity
;
Postoperative Complications
;
Retrospective Studies
3.Prolaction May not Stimulate Generation of New Cells after Transient Focal Cerebral Ischemia in Adult Male Rat Brain: a Preliminary Study.
Kyusik KANG ; Soon Tae LEE ; Hyung Min KWON ; Min Jeong KIM ; Young Ju KIM ; Kyong Mi LEE ; Jong Moo PARK ; Kon CHU ; Manho KIM ; Byung Woo YOON
Journal of the Korean Neurological Association 2006;24(2):141-147
BACKGROUND: Production of neuronal progenitors is usually stimulated in the forebrain subventricular zone of mice after the intracerebroventricular infusion of prolactin. As a preliminary study, we infused prolactin to the male rat brain to test the hypothesis that prolactin promotes new cell proliferation in the brain and functional recovery after focal ischemia. METHODS: Male rats were subjected to intraluminal middle cerebral artery occlusion. Prolactin was administered to the surface of the brain for 5 or 14 days starting 24 or 48 hours after stroke onset at doses of 6.4 microgram per day. We administered the same volume of saline to the other ischemic rats used as a control group. Some rats were killed 6 or 17 days after stroke for analysis of infarct volume and newly generated cells within the subventricular zone and the striatum. The other rats were tested for neurological recovery 24 days after stroke. RESULTS: There was no significant difference of infarct volume among the experiment groups. Treatment with prolactin did not increase the numbers of bromodeoxyuridine-immunoreactive cells in the subventricular zone and the striatum. Treatment with prolactin did not enhance neurological recovery in all tests performed. CONCLUSIONS: In this preliminary study, prolactin did not enhance new cell generation in the male rat brain nor reduce the neurological deficits after ischemic stroke.
Adult*
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Animals
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Brain Ischemia*
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Brain*
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Cell Proliferation
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Humans
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Infarction, Middle Cerebral Artery
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Infusions, Intraventricular
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Ischemia
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Male*
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Mice
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Neurons
;
Prolactin
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Prosencephalon
;
Rats*
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Stem Cells
;
Stroke
4.Characteristic Findings and Their Clinical Appraisal of Proctography and Cinedefecography in Patients with Pelvic Outlet Obstructive Disease.
Kyong Rae KIM ; Young Sok KIM ; Soon Sup CHUNG ; Chang Hee LEE ; Gi Bong CHAE ; Hye Rin ROH ; Won Jin CHOI ; Ung Chae PARK
Journal of the Korean Society of Coloproctology 2003;19(2):94-100
PURPOSE: We were assessed the characteristic findings of defecography and cinedefecography in patients with pelvic outlet obstructive disease, and compared the characteristic physiologic findings between proctography and cinedefecography. METHODS: Physiologic findings of 196 patients who were performed at least two items of physiologic tests were retrospectively evaluated. Patients were categorized as rectocele (Group I: n=119), nonrelaxing puborectalis syndrome (Group II: n=58), rectoanal intussusception (Group III: n=16), significant sigmoidocele (Group IV: n=3). The proctographic and cinedefecographic features were analyzed according to disease categories. The sensitivity, specificity, accuracy, false positive rate, false negative rate, diagnostic rate, and reproducibility were calculated, and we analyzed the difference between proctography and cinedefecography according to the disease groups. RESULTS: On the proctographic examinations; 1) 112 patients were confirmed as a clinically significant rectocele (n=128, sensitivity; 94%, specificity; 79%, accuracy; 88%, false positive rate; 21%, false negative rate; 6%, kappa; 0.749). 2) A clinically significant nonrelaxing puborectalis were 36 patients (n=73, sensitivity; 62%, specificity; 73%, accuracy; 70%, false positive rate; 27%, false negative rate; 38%, kappa; 0.328). 3) 12 patients were confirmed as significant rectoanal intussusception (n=31, sensitivity; 75%, specificity; 89%, accuracy; 88%, false positive rate; 11%, false negative rate; 25%, kappa; 0.425). 4) 3 patients were confirmed as clinically significant sigmoidocele (n=15, sensitivity; 100%, specificity; 94%, accuracy; 94%, false positive rate; 6%, false negative rate; 0%, kappa; 0.316). On the combination of proctography and cinedefecography; 1) 117 patients were confirmed as a clinically significant rectocele (n=122, sensitivity; 98%, specificity; 94%, accuracy; 96%, false positive rate; 6%, false negative rate; 2%, kappa; 0.925). 2) A clinically significant nonrelaxing puborectalis were 50 patients (n=64, sensitivity; 86%, specificity; 90%, accuracy; 88%, false positive rate; 10%, false negative rate; 14%, kappa; 0.738). 3) 16 patients were confirmed as significant rectoanal intussusception (n=22, sensitivity; 100%, specificity; 97%, accuracy; 97%, false positive rate; 3%, false negative rate; 0%, kappa; 0.826). 4) 3 patients were confirmed as clinically significant sigmoidocele (n=9, sensitivity; 100%, specificity; 97%, accuracy; 97%, false positive rate; 3%, false negative rate; 0%, kappa; 0.488). As compared with combined study (proctography plus cinedefecography), the proctography show decreased diagnostic rates in the evaluation of rectocele (P<0.05), nonrelaxing puborectalis (P<0.01), and rectoanal intussusception (P<0.05). And, the proctography also show increased false positive rate in the evaluation of rectocele (P<0.01), nonrelaxing puborectalis (P<0.01), and rectoanal intussusception (P<0.05). CONCLUSIONS: In our study, proctography showed a tendency to overdiagnosis. Therefore, the combined study of proctography and cinedefecography should be taken as a diagnostic tools for pelvic outlet obstructive disease. Adhering to these findings, other anorectal physiologic studies should be added for the clinically significant diagnosis.
Defecography
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Diagnosis
;
Humans
;
Intussusception
;
Rectocele
;
Retrospective Studies
;
Sensitivity and Specificity
5.A report on the high frequency beam in hemorrhoid management based on patients' satisfaction.
Ki Bum KWON ; Chang Hoon KOO ; Hyuk Jung KWEON ; Kyong Kon KIM ; Bang Bu YOUN ; Keon Oh LEE ; Kwang Soo RHO
Journal of the Korean Academy of Family Medicine 2001;22(7):1119-1125
BACKGROUND: The most frequent disease seen in the anal area is hemorrhoid. The main therapeutic approach has been surgical treatment. However, in case of first degree and second degree hemorroids, the high frequency therapy is available. It can be applied on the OPD basis by the family pratitioners. Method: The data have been collected between Nov. 1997 and Apr. 1999, 464 cases are surveyed on the basis of sex, age, symptom duration, main symptom, location and duration of hemorrhoid, associated anal disease, therapeutic complication, and patients subjective satisfaction. Only 220 out of the 464 cases were available for the patients satisfaction study because of limited follow up study. RESULT: The sex ratio is 1.18:1 (252 in male, 212 in female). Age distribution shows a clustering pattern around the middle age(158 cases in the 30s, and 142 in the 40s respectively). Symptom duration before their first hospital visit reveals 118 cases(25.4%). under 5 years, 105 cases(22.6%) over 10 years, 102 cases(22.1%) 5 to 10 years orderly. The main symptom includes hemorrhoidal mass, bleeding, and pain. 146 cases(31.5%) had all the symptom descrived above. Patients with mass and bleeding were 122 patients(26.3%). In case of the degee of internal hemorrhoid, the second degree of hemorrhoid was the most common(386 cases: 83.2%) followed by the first degree(43 cases: 9.3%), the third degree (24 cases: 5.1%) and the forth degree(11 cases:2.4%). Total number of the patients with therapeutic complication were 99 cases. The complications were acute urinary retension (46cases: 46.5%), perianal edema (30 cases: 30.3%), bleeding (18cases: 18.2%) and anal stricture (5 cases: 5.0%). Satisfaction survey was based on the 220 follow up case study. 125 cases revealed very satisfied.(56.8%), 66 slightly satisfied (30.0%) and 29 unsatisfied.(13.2%). CONCLUSION: As shown in the study above, the high frequency therapy provided the patients with the high level of satisfaction. Based on the this fact, it is suggested to the family practitioners.
Age Distribution
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Constriction, Pathologic
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Edema
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Follow-Up Studies
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Hemorrhage
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Hemorrhoids*
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Humans
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Male
;
Sex Ratio